Provider Demographics
NPI:1467475871
Name:SMYRNA PULMONARY AND SLEEP ASSOCIATES PLLC
Entity Type:Organization
Organization Name:SMYRNA PULMONARY AND SLEEP ASSOCIATES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:PRAKASH
Authorized Official - Middle Name:B
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:615-355-5105
Mailing Address - Street 1:13181 OLD NASHVILLE HWY
Mailing Address - Street 2:SUITE 150
Mailing Address - City:SMYRNA
Mailing Address - State:TN
Mailing Address - Zip Code:37167-4032
Mailing Address - Country:US
Mailing Address - Phone:615-355-5105
Mailing Address - Fax:615-355-5195
Practice Address - Street 1:13181 OLD NASHVILLE HWY
Practice Address - Street 2:SUITE 150
Practice Address - City:SMYRNA
Practice Address - State:TN
Practice Address - Zip Code:37167-4032
Practice Address - Country:US
Practice Address - Phone:615-355-5105
Practice Address - Fax:615-355-5195
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-26
Last Update Date:2016-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD36535207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3735848Medicaid
TN3735848Medicare PIN
H76405Medicare UPIN